Preventing Nursing Home Elder Abuse
Do you have concerns for your loved one?
Anyone who believes an elder is in immediate danger, has witnessed abuse, neglect or exploitation, or believes the senior is in danger is obligated to contact 911, or local police authorities, immediately.
If you suspect abuse, neglect or exploitation, health care professionals have a number of recommended interventions and diagnostic tools available to either prevent or diagnose abuse, neglect or exploitation. Every health care provider that suspects abuse has an obligation under law to report abuse, neglect or exploitation. The choice of measures used to diagnose varies dependant upon the input received, the type of condition that is brought to their attention, the circumstances surrounding the claim, and the permission required to perform such evaluations. A few office questions during a medical exam may suffice in some circumstances. By comparison, a simple screening tool would a beginning step to a detailed assessment if in a home setting where an allegation of abuse has been filed.
According to a guide published by JM Daly at the University of Iowa Gerontological Nursing Interventions Research Center, dated December 2004, health professionals may start with patient history, physical assessment and by interviewing the patient and significant others present with the patient. The health care provider may ask simple questions like, “How are things at home?” and “Do you feel safe at home?” or they may utilize the following tools while questioning:
- Health, Attitudes Toward Aging, Living Arrangements, and Finances (HALF)
- Elder Assessment Instruments (EAI)
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- Actual Abuse Tool
- Questions to elicit elder abuse
There is a cognitive assessment screen called “Mini-Mental State Examination (MMSE)”, and a myriad of risk assessment tools which can be utilized, including:
- Indicators of Abuse Screen (IOA)
- Index of Spouse Abuse
- Partner Violence Screen (PVS)
- Two Question Abuse Screen
- Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST)
- Risk of Abuse Tool
- Vulnerability to Abuse Screening Scale (VASS)
- Suspected Abuse Tool
It is also important for health care providers to provide a way to recognize those who may be most likely to benefit from interventions and services. Assessment criteria recommendations for assessing those most at-risk to benefit by intervention and services, according to the University of Iowa Gerontological Nursing Interventions Research Center, include:
- Persons with physical, functional, or cognitive impairment
- Persons who have mental illness, alcoholism, or drug abuse problems
- Persons who are socially isolated or have a poor social network
- Persons who are dependent on others
- Persons with a past history of abusive relationships
- Persons with financial or other family problems
- Persons who reside in inadequate housing or unsafe conditions
- Persons who are in poor health
- Persons whose caregiver is stressed/frustrated with the difficult task of caring for an older person
- Persons whose caregiver has mental illness, alcoholism, or drug abuse problems
- Persons whose caregiver has inadequate financial resources
- Persons whose caregiver has health problems
Diagnosis of abuse, neglect and/or exploitation may lead to a police investigation, a formal complaint filed with Adult Protective Services, immediate medical care for injuries, and/or a combination of appropriate intervention and services. Such measures may include:
- Abuse protection support
- Respite care
- Anger control assistance
- Caregiver support
- Coping enhancements
- Counseling
- Decision-making support
- Emotional support
- Family process maintenance
- Family therapy
- Patient rights protection
- Use of support groups
- Support system enhancement
- Cognitive restructuring
- Communication enhancement of such things like hearing, speech and vision devices
- Violence prevention
- Financial assistance
- Health policy monitoring
- Program development
- Risk identification
- Role enhancement
- Safety surveillance
If abuse, neglect or exploitation is diagnosed, proper authorities are required to investigate. Adult Protective Services will likely get involved. Those who are victims of abuse, neglect and/or exploitation may wish to seek legal recourse and/or compensation for their injuries.
